Today we got back from our trip to Hawaii. Because Fred just took a bunch of time off, we had to schedule the nuchal for today so he didn’t miss work again. We were home by 9:30am and really tired, so we napped before our 3:30pm appointment.
I found out which doctor was on the unit that day (the perks of going to the hospital where you work) and texted her in the morning. I wrote, “are you in FEU today?” She wrote back and said “yes, see you at 3:30! :) “ I was really happy she knew already I was coming, even without me telling her.
The wait time to be seen wasn’t too bad (I’ve heard otherwise at times). The tech we got was not super friendly or talkative. She barely spoke to us through the scan. It was so different than our first ultrasound. I told her my due date and she said, "well we base it on your period." I said fine and didn’t argue, knowing I would talk to the doctor afterwards to get it revised.
Midwife note: An accurate due date is really important, especially for a first baby. The most accurate time to have a pregnancy dated by sonogram is around 7-8 weeks. At this time, the due date is based on your last period, but if there is a discrepancy of more than 5 days, the due date is changed.
At 9-13 weeks, the due date is based on your last period, but if there is a discrepancy of more than 7 days, the due date is changed.
An accurate due date is important, especially for women who go past their due dates. It can help you to avoid an early induction (the cutoff for induction is no more than 42 weeks in most cases, but often practices say even earlier like 41 weeks).
The fetus was in there and now looks like a baby! Crazy! The fetus was also not very cooperative. It wouldn’t move in the right position for the nuchal. Finally she got it and it was normal. Phew. She printed us two pictures (that honestly aren’t very good).
Midwife note: The nuchal fold is an area of the back of the baby's neck. This is measured as a screening for chromosomal abnormalities. In things like Trisomy 21 (Down's syndrome) the nuchal fold can be increased.
It is still considered a screening and there are times where the neck fold is elevated that things are normal with the fetus. If it is elevated, further testing (like NIPT or invasive testing) are recommended.
I asked that the doctor come into the room and she did. She was super friendly and awesome, as usual. We talked about the due date and showed her the first scan. She changed my due date in the system. I’m so happy because it would have been 10 full days off had we not changed it, and the new measurement wouldn’t have indicated a change from last period. Long story short, really happy we had the early scan.
We left, happy with everything. We went to dinner at a place called Empanada Mama, which is an old favorite restaurant, and had a great dinner. We sent pics to our parents which they were very happy about.
Today was our first official prenatal visit with the midwife, Jo.
We scheduled our visit first thing in the morning so as to (hopefully) avoid any of our clients seeing me.
I had already done my bloodwork the week prior, which was all back for Jo to review. My Panorama test is still pending though, which is nerve wracking. I found out yesterday that the lab hadn’t even started to process my results yet, and that made me go crazy. I basically called the lab, talked to whoever I could and even reached out to the lab rep, about it. It’s still pending without a result date. I completely understand the feelings people have about this test now (and we aren’t even finding out the sex).
Midwife note: Non-invasive prenatal testing (NIPT) or cell-free fetal DNA (cffDNA) is a test done as early as 9-10 weeks. This test screens for Trisomy 21 (Down's syndrome), Trisomy 18 and a few other chromosomal abnormalities. This test is quite accurate as a screening (NOT diagnostic as it doesn't test for everything), with 98-99% accuracy. Many people like it because you can also find out the sex of the baby.
This test is relatively new (within the last 5-10 years) and was originally offered to only to high risk women (those over 35, family history of abnormalities, etc). Now it's becoming more of the standard of care. It is similar to the sequential screen, which tests for abnormalities and is also not as accurate. In our practice, we pretty much offer this test to everyone.
Our visit was a pretty standard first prenatal visit. We talked about my medical history, medications/supplements and what to expect for the pregnancy. Jo catered a lot of the visit toward Fred and focused on what he didn’t know.
We then attempted to listen to the heartbeat. Since we were able to hear it already last week at home, I felt confident we would find it. It sounded normal.
We did see one of my clients on the way out. I had attempted to have Fred leave first, but it was probably kind of obvious what was going on. Luckily, our clients probably won’t ask questions.
A pregnant midwife living and working in New York City